Re: NYC DOC/ Post-op 12 days

[Guest guest]

I had huge swelling, although it didn't hurt. In fact, I think it cushioned my

CP. I'd kinda like to have it back.

I have an interesting situation coming up. My " employer " (I'm retired, but it's

the same entity (CalPERS) that handles my health insurance) refuses to renew

with my med. center. Some of you may remember that I've complained about the

fact that my former med. ctr. bumbled around for 5 years w/o helping me w/my

knee, including for a year after an MRI was taken (that MRI was so bad that no

doctor could tell the R knee from the L knee) -- and I'm talking about a UC

medical center, not some guy with a fake diploma. Last fall I switched med.

ctrs, immediately found a great OS, and had my operation w/i 3 months. Now I'm

going to be forced to return to the old med. ctr, and I won't be allowed to see

my OS unless I sign up for the PPO (vs. the HMO), which would cost me $230/mo

plus a $2000/yr deductible, and 10% of any surgery. UNLESS I have a knee

operation just before the end of the year, in which case, the insurance company

would implement " continuity of care " for 3 months. I think I tore my medial

meniscus last May hiking in the snow (falling through where there were air

cavities underneath). So between now & the end of the year I have to get a new

MRI, arrange for the surgery, have the surgery, and get into my insurance

company's continuity thing. Since my CP still hurts, I'm tempted to have a TKR

instead of just having the meniscus fixed, which will eventually tear again

anyway.

I attended one of the meetings where PERS talked about whether or not to keep my

med ctr and it was clear to me that there's some political thing going on. If I

were in the PPO, I could keep my surgeon. It's infuriating.

When I hit 65 (I'm currently 62), I'll be able to get that PPO for free, no

deductible, 100% paid for (bec. it will then be a MediCare supplement). So do I

wait 3 years for a TKR or do I do it this year? It's not a trivial operation.

All kinds of things can go wrong.

Sigh.

Ann

NYC DOC/ Post-op 12 days

Hi,

who ever it was that needed an NYC doc. I have a physiatrist that is

OK. You can reason with him and ask for a bunch of scans etc. hes

easy to talk to. if you want the name email me.

im 12 days pos-op. i still have swelling. when i hold my leg strait.

the bottom part of my knee bulges out and when i bend my knee i fell

stiffness from swelling. Did anyone else have pain after the scope

and scrape before feeling better.

I really feel strongly that the synovitis I had was causing the

pain, but yet i feel more apin and swelling in that area after the

operation. is this normal?

...... im seeing my doctor (Dr. Fulkerson) tomorrow and Ill ask

him.....

[Guest guest]

Good Luck with you decision Ann.

Insurance for retired people is such a horrible game

companies are playing now a days. They keep trying to save

the bottom line by cutting the retires health coverages and plans.

It's horrible how you findly found a good doc, and now

have to possibly change back to where you don't like.

Whether or not to do the knee replacement. Thats a tough

decision. I've talked to hip replacement people and they have

talked to other knee replacement people, and they say its

worse. One big thing is to keep doing all your strengthening

exercises. That way either if you decide for the little sergery,

or the big one, you legs will be stronger.

So how much difficulty is the knee giving you now a days?

I guess you have to gauge your pain level, your activity level,

etc to know which option is best for you.

One other thing to look into is the rehab with physical therapy

after the sergery. My aunt has had both of her hips replaced. One

with her old insurance and one with medicare. She was allowed a lot

more therapy sessions (pt) with the medicare. This last hip was

replaced in jan. She said it has gone much better. Maybe thats one

thing to look into since therapy with no insurance is mighty

expensive. and without adaquate therapy in getting you back on full

course, wouldn't be a desirable option. I'm thinking this more for

the knee replacement. You probably already know enough for after

another smaller knee sergery.

Good Luck in your choice, and I feel your pain with insurance

companies.

Connie

[Guest guest]

>Good Luck with you decision Ann.

Thanks.

>Insurance for retired people is such a horrible game

companies are playing now a days. They keep trying to save

the bottom line by cutting the retires health coverages and plans.

I'm lucky in that I worked for the State (CA) and my insurance will cover me

anywhere in the world (I'll actually be better off when I'm covered by it when I

hit 65 than I am now), and anywhere in the US as long as the doc takes MediCare.

But I agree-- MediCare doesn't pay enough to satisfy most docs & the provider

pool has shrunk. Then there's Rx's when you're on MediCare. My insurance will

pay, but for most people, having to pay for 5 or 6 meds is a real bankbreaker.

>It's horrible how you findly found a good doc, and now

have to possibly change back to where you don't like.

And it was a political decision by PERS. PERS contracted with Blue Shield to

pay them a certain amt per employee/retiree. Then Blue Shield contracted with

providers. Blue Shield and Sutter (my new med ctr) had already agreed on a

contract for 2005. Whatever they agreed on, it wasn't going to cost PERS any

more. I suspect it was against some law or regulation for PERS to force B.S. to

back out of their contract w/Sutter (it is under appeal to the State's Managed

Care board, but both PERS and the managed care board belong to the State, so

what are the odds that the board would find in the employees' favor?). What

really happened was that the union that local hospital workers belong to was

unhappy with its negotiations with Sutter and presented " evidence " in a very

slick presentation -- profesional slide shows, slick brochures -- to the PERS

committee " proving " that Sutter hospitals charge more than any other northern CA

hospitals for their services. PERS just took the union's word for it. So

basically what happened was that the union used PERS as leverage against Sutter

and us patients are paying for it. I don't now why PERS went along with it

since it was no skin off their nose, and the State doesn't usually side with

unions. The ironic thing is that my knee surgery wouldn't take place in any

Sutter hospital -- they contract with an outside agency to provide little

surgical centers for outpatient surgeires, and those outpatient center have

nothing to do with the union negotiations. But I talked to B.S. and they said

that my PCP or specialist couldn't be a Sutter doctor unless that doctor agreed

to do his/her surgeries in a non-Sutter hospital. I hate it when committes make

decisions. And you can bet that the PERS board members are all covered by

PERS's PPO & don't have to worry about switching doctors.

>Whether or not to do the knee replacement. Thats a tough

decision. I've talked to hip replacement people and they have

talked to other knee replacement people, and they say its

worse. One big thing is to keep doing all your strengthening

exercises. That way either if you decide for the little sergery,

or the big one, you legs will be stronger.

Definitely.

>So how much difficulty is the knee giving you now a days?

Even though I think I tore the medial meniscus, it hasn't given me

debilitating pain for my normal and gym activities so far. I'm mainly worried

about making it worse. I think if my stupid UC doctors had been on the ball,

caught the lateral meniscal tear early, I'd have had to have less meniscus

removed. Other than the probably torn medial meniscus, the lateral meniscus

isn't giving me any problems (I had thought I'd feel bone on bone, and I guess I

will eventually, but right now it's fine),but will wear away over time. My

biggest problem is the CP. As long as I use knee tape, I can do the gym

exercisees -- and I think I could hike 6 miles or so, but haven't tried -- it's

a 200 mile round trip to the trailhead. I can see my VMO developing. It's

pretty impressive., though doesn't match the other one yet.

>I guess you have to gauge your pain level, your activity level,

etc to know which option is best for you.

One other thing to look into is the rehab with physical therapy

after the sergery. My aunt has had both of her hips replaced. One

with her old insurance and one with medicare. She was allowed a lot

more therapy sessions (pt) with the medicare.

That's interesting.

>This last hip was

replaced in jan. She said it has gone much better. Maybe thats one

thing to look into since therapy with no insurance is mighty

expensive. and without adaquate therapy in getting you back on full

course, wouldn't be a desirable option. I'm thinking this more for

the knee replacement. You probably already know enough for after

another smaller knee sergery.

According to B.S. yesterday, if I had a knee operation (of any kind) in Dec.,

I'd be covered for 3 months of followup. I don't know what the usual rehab

period is for TKRs. How long was your aunt in rehab?

>Good Luck in your choice, and I feel your pain with insurance

companies.

Connie

Thanks again. It's so frustrataing. I was raised in the " insurance covers

everthing " era, and you could just make an appt with a specialiast w/o someone

reviewing your file.

Ann

[Guest guest]

hi ann,

i just got back frim dr fulkerson and he said that

its normal to have a lot of pain after they've prodded

at the synovium around the knee cap and the fellow

said that it may remain swollen for 3 wks or so.

honestly, id fix the meniscus first and wait 3 yrs to

get the tkr for free. who knows they may change

techniques in a few yrs.

--farah

-- ruby2zdy <ruby2zdy@...> wrote:

> I had huge swelling, although it didn't hurt. In

> fact, I think it cushioned my CP. I'd kinda like to

> have it back.

>

> I have an interesting situation coming up. My

> " employer " (I'm retired, but it's the same entity

> (CalPERS) that handles my health insurance) refuses

> to renew with my med. center. Some of you may

> remember that I've complained about the fact that my

> former med. ctr. bumbled around for 5 years w/o

> helping me w/my knee, including for a year after an

> MRI was taken (that MRI was so bad that no doctor

> could tell the R knee from the L knee) -- and I'm

> talking about a UC medical center, not some guy with

> a fake diploma. Last fall I switched med. ctrs,

> immediately found a great OS, and had my operation

> w/i 3 months. Now I'm going to be forced to return

> to the old med. ctr, and I won't be allowed to see

> my OS unless I sign up for the PPO (vs. the HMO),

> which would cost me $230/mo plus a $2000/yr

> deductible, and 10% of any surgery. UNLESS I have a

> knee operation just before the end of the year, in

> which case, the insurance company would implement

> " continuity of care " for 3 months. I think I tore

> my medial meniscus last May hiking in the snow

> (falling through where there were air cavities

> underneath). So between now & the end of the year I

> have to get a new MRI, arrange for the surgery, have

> the surgery, and get into my insurance company's

> continuity thing. Since my CP still hurts, I'm

> tempted to have a TKR instead of just having the

> meniscus fixed, which will eventually tear again

> anyway.

>

> I attended one of the meetings where PERS talked

> about whether or not to keep my med ctr and it was

> clear to me that there's some political thing going

> on. If I were in the PPO, I could keep my surgeon.

> It's infuriating.

>

> When I hit 65 (I'm currently 62), I'll be able to

> get that PPO for free, no deductible, 100% paid for

> (bec. it will then be a MediCare supplement). So do

> I wait 3 years for a TKR or do I do it this year?

> It's not a trivial operation. All kinds of things

> can go wrong.

>

> Sigh.

>

> Ann

> NYC DOC/

> Post-op 12 days

>

>

> Hi,

> who ever it was that needed an NYC doc. I have a

> physiatrist that is

> OK. You can reason with him and ask for a bunch of

> scans etc. hes

> easy to talk to. if you want the name email me.

> im 12 days pos-op. i still have swelling. when i

> hold my leg strait.

> the bottom part of my knee bulges out and when i

> bend my knee i fell

> stiffness from swelling. Did anyone else have pain

> after the scope

> and scrape before feeling better.

> I really feel strongly that the synovitis I had

> was causing the

> pain, but yet i feel more apin and swelling in

> that area after the

> operation. is this normal?

> ...... im seeing my doctor (Dr. Fulkerson)

> tomorrow and Ill ask

> him.....

>

>

>

[Guest guest]

Just what I was thinking on the way home. And maybe a LR with the meniscus,

since no matter how strong I make my VMO, I still have to tape my knee.

Thanks.

Ann

NYC DOC/

> Post-op 12 days

>

>

> Hi,

> who ever it was that needed an NYC doc. I have a

> physiatrist that is

> OK. You can reason with him and ask for a bunch of

> scans etc. hes

> easy to talk to. if you want the name email me.

> im 12 days pos-op. i still have swelling. when i

> hold my leg strait.

> the bottom part of my knee bulges out and when i

> bend my knee i fell

> stiffness from swelling. Did anyone else have pain

> after the scope

> and scrape before feeling better.

> I really feel strongly that the synovitis I had

> was causing the

> pain, but yet i feel more apin and swelling in

> that area after the

> operation. is this normal?

> ...... im seeing my doctor (Dr. Fulkerson)

> tomorrow and Ill ask

> him.....

>

>

>